Population Health Publications

This obesity cost report, prepared for the Alberta Cancer Board, delves into considerable detail
on the methodologies and data sources appropriate to risk factor costing studies. It also uses the
most recent available epidemiological data to provide new information on the cost of obesity-related
illnesses not included in GPI Atlantic's original 2000-01 obesity cost studies, including, for example,
14 different cancer types now reliably linked to obesity. Illness costs by diagnostic category are
summed to provide an aggregate estimate for obesity costs in Alberta.

This report provides the technical background information that would be required to produce a
report assessing the health costs associated with poverty for Canada. As such, it reviews
methodologies used in previous studies to assess: the broad social and economic costs of poverty
in Canada (Calgary), the United States, and Europe; methodologies used in socioeconomic health
disparity studies with an emphasis on studies from New Zealand and The Netherlands, as well as
general cost of illness studies; basic information on Canadian and international poverty
measures; and evidence for the association of poverty with various health indicators. In addition,
it briefly reviews several groups that are especially vulnerable to the health impacts of poverty,
and other social issues that influence the relationship between poverty and health.

The emphasis of this report is on the information and data that would be required to assess the
external health costs of poverty, rather than the private costs incurred by those living in poverty.
These external health costs, which all have major policy implications in terms of government
decisions to invest in poverty reduction programs, include costs to the health care system that
result from the association between poorer health outcomes and low income. There are, however,
other costs, which result from the effects of poverty on society in general. These include costs
related to the criminal justice system, social assistance programs, educational systems, and to
employment and productivity. In addition, other social issues that result in social exclusion, such
as homelessness, food insecurity, and environmental problems also register as costs. Due to time
and resource limitations, these social costs are explored only briefly in this report.

The review is intended as a useful starting point for further work in this area—in particular the
eventual development of a full-fledged study assessing the health and other social costs of
poverty for Canada and the provinces that will hopefully make a significant contribution to
advancing work in the field of social and economic determinants of health. In the short term, it is
hoped that even this modest first step of summarizing key results from the existing evidence can
raise the profile of this important issue and facilitate the practical application of this information
to decisions made in the policy arena and in this field of research.

The purpose of this report is to provide the Public Health Agency of Canada (PHAC), and
specifically, the Population Health Promotion Expert Group (PHPEG) and the Healthy Living
Issue Group (HLIG) of the Pan-Canadian Public Health Network (PHN) with information,
analysis and suggestions for a common set of health disparities indicators, and a feasible
approach to their implementation in the Canadian context. The objective is to identify indicators
that could lead to an agreed upon set of measures that could be used by Federal-
Provincial/Territorial (F-P/T) jurisdictions to assess progress in the reduction of health
disparities. Specifically, the mandate of the report is to include:

A comprehensive review of existing Canadian and international data sources to identify
indicators of health disparities for which data are available,

A gap analysis to determine indicators which are desirable and for which data are not
being collected, and

Recommendations for a common set of indicators of health disparities and a feasible
approach for their implementation in the Canadian context.

The full economic and social costs of tobacco use in Nova Scotia were reported by GPI Atlantic in The Cost of Tobacco in Nova Scotia (2000). This current report uses the latest and most widely accepted research and analytical techniques to update and enhance our knowledge of the
real costs of tobacco use to Nova Scotians. This update is necessary in light of recent research findings, and because new results have become available to provide evidence of the impacts of comprehensive tobacco control strategies in other jurisdictions. Most importantly, tobacco use in
the province has declined significantly since 2000, largely as a result of comprehensive tobacco reduction strategies implemented by the Province of Nova Scotia, so the trends outlined in the 2000 report (based on the most recent 1999 data available at that time) also required updating.

Physical inactivity costs the Nova Scotia economy an additional $247 million each year in indirect productivity losses due to premature death and disability. Adding direct and indirect costs, the total economic burden of physical inactivity in Nova Scotia is estimated at $354 million annually.

Direct and indirect short and long-term economic impacts of obesity on health costs and economic productivity in Nova Scotia, using relative risk ratios for ten illnesses, and analysis of social causes.

An examination of statistical evidence finding that Atlantic Canadians had higher rates of physical activity than other Canadians in 1985, but lower rates today. A gender analysis finds that this negative trend in Atlantic Canada is entirely due to a dramatic decline in levels of physical activity by men, as female rates of exercise have actually increased. By contrast Canadian men outside the Atlantic region are exercising more.